Appliance for the treatment of the larynx with ultra-violet rays



March 17, 1936. CEMACH 2,034,388

APPLIANCE FOR THE TREATMENT OF THE LARYNX WITH ULTRA VIOLET RAYS FiledMay 2, 1932 25 7 I I J 6% 1M M J Patented Mar. 17, 1936 UNITED STATESPATENT OFFICE Alexander Cemach, Vienna, Austria I Application May 2,1932, Serial No. 608,758 In Austria May 18, 1931 11 Claims. (01.174-177) This invention relates to an appliance for the treatment of thelarynx with ultra-violet rays. The hitherto known appliances for thispurpose consist essentially of a casing, containing a mercury-vapourlamp and of a fiat ray-conducting tube adjoining the said casing. Thistube is intended to be introduced into the patients larynx and thus toexpose the part to be treated to the ultra-violet rays from themercury-vapour lamp.

Since, with this typ'e'of construction, the rayconducting tube employedmust be straight, it will be clear that the patients head must assume aparticular position to permit of the introduction of the ray-conductingtube into the larynx. For

this purpose the patient is required to lie in a supine position on atable and to allow the head to hang down over the edge of this table.The patient is then held in this particularly uncomfortable position bythe irradiating appliance itself, this latter being mounted upon astand. Irradiating appliances of this nature are very complicated inconstruction and cumbersome in use. The most serious objection thereto,however, is the fact that the ultra-violet rays can never in actual factreach all parts of the larynx to be irradiated. This statement appliesmore particularly to those parts which lie in the shadow thrown by theepiglottis.

There have been, proposed, appliances for the treatment of the larynxwith ultra-violet rays in which a, curved quartz glass rod, or a lightconducting member, consisting .of several arcuately curved closed quartzmembers, serve for conducting into the larynx the rays of a source oflight held outside the mouth. Suchappliances have, however, theprohibitive drawback that the ultra-violet rays are largely absorbed inthe long path which they must traverse through the quartz conductor, andit is not possible to conduct the rays to all sides of the larynx belowthe epiglottis.

The present invention relates to an appliance for the treatment of thelarynx with the ultraviolet rays emitted by a mercury-vapour lamp inwhich the discharge space of the vapour lamp is provided within the endportion of a hollow body" which is made of material permeable toultraviolet rays, and which is so dimensioned and curved that it can beintroduced simply into the larynx in the manner of other instrumentsemployed in the examination and treatment of the larynx. The end portionof the hollow member or body which emits the ultra-violet rays can bepassed over the open epiglottis and brought into a position close up tothe vocal cords, so that the ultra-violet rays can effectually reach allparts of the larynx, the more so since the efiective portion of theappliance is so movable within the larynx that the irradiating tip canalways be brought into the most effective position. At the same time,the patient can assume a comfortable position, and the handling of theinstrument by the physician is extremely simple.

I One form of appliances embodying the invention is illustrated, by wayof example, in the accompanying drawing, in which: 10

Fig. 1 shows the appliance in side elevation.

Fig. 2 is a longitudinal section of the same.

Fig. 3 is a front elevation of the appliance, partly in section,

Fig. 4 is a rear view of the appliance, showing 15 the electric cableconnection and the connections for the cooling circulation.

Referring to the drawing, the appliance consists essentially of ametallic sleeve I tightly adjoining one end of which there is a hollowbody 2 20 which is curved crook-shaped and slightly tapered in towardsits outer closed end. This hollow body 2 can consist in its entirety ofmaterial which is pervious to ultra-violet rays, such as, for example,quartz glass. In the interior of this hollow body 25 2 there is provideda U-shaped and beak-shaped bent tube 3 having suitable limbs (see alsoFig.

,3) which is made of material pervious to ultra- U-shaped andbeak-shaped tube 3, and the outer 35 ends of these lead-ins 5 areconnected to the core conductors of the cable 6 by means of theterminals l which are screwed into a transverse member 8 in the metallicsleeve I. The cable 6 is taken out through a hole in the closing plug 940 ot the sleeve The interior of the hollow body 2 is closed off fromthe interior of the sleeve I by means of the transverse partition l0.Within the sleeve i there is provided a tube II which is introducedthrough a bore in the plug 9, and terminates in a bore in the partitionl0. There is further pro-' vided a tube l2 which is likewise introducedthrough a hole in the plug 9, which traverses the partitions 8 and I0,and which projects into the interior of the hollow body 2. The tubes IIand I2 can be madeof metal and are provided at their ends projectingfrom the plug 9 with connecting pieces I3 to which flexible tubes can beattached. The tube 12 is connected to a water l To start the lamp thecurrent leads 5 are con- 4 nected to a current supply of suitably highvoltage, and the appliance is so held by the handle 14 that the sharplycurved portion 4 of the U- shaped tube 3 of the mercury-vapour lamp isdirected downwards. The appliance is then so turned that the sharplycurved portion of the U-shaped tube 3 is directed upwards, so that themercury flows away from the sharply curved end portion into the two sidelimbs of the U-shaped tube. In this manner a gap is produced between thetwo columns of mercury, which gap can be so dimensioned by the correctdetermination of the quantity of mercury inserted in the U-tube that anarc-discharge is started between these two columns. The inherentpressure of the mercury vapour thus generated between the two.

mercury electrodes in the sharply curved end portion of the U-tube issufficient to prevent the two columns of mercury from coalescing in thesaid end portion when the appliance is again turned with its pointed enddownwards. When the arc-discharge has once been started in the describedmanner, the appliance can thus be rotated, turned, and tilted in anydirection without causing the mercury electrodes to approach each other,and it is thus possible to maintain the arc in any position of theappliance, a feature necessary to enable the appliance to be introducedinto the larynx.

The possibility of maintaining the arc-discharge at all positions of theappliance is ensured by the correct choice of the shape and dimensionsof the discharge space of the lamp, so that the inherent pressure of themercury vapour, when once ignition has been effected, shall besufiicient to hold the two electrodes apart in all positions of theappliance. To this end the sharply curved end portion 4 of the U-tube 3can be made of slightly narrower bore than the two side limbs of thistube, and that either throughout this portion or at certain points, andthe constriction may even be such as to be of a capillary order, so thatcapillary resistance aids in preventing the mercury columns fromcoalescing. In order in this case to bring the mercury columns togetherand then to separate them at the start, as is necessary for the purposeof ignition, the appliance must be shaken or jarred in the manner usualwith clinical thermometers to-bring down the mercury column.

It is advisable as a rule to restrict emission to the extreme outer endof the mercury-vapour lamp, and to this end it is possible to providethe hollow body 2 with an impermeable protective sleeve I5 or with animpermeable coating, leaving only the extreme tip 4 of the lamp free toemit rays. It would also be possible to make the greater part of thehollow body 2 of material impervious to ultra-violet rays and to fit aseparate tip of pervious material atthe extreme end only.

With the employment of a mercury-vapo lamp consisting essentially of aU-tube the two electrodes can also be held apart by the insertion in thesharply bent portion of this tube of a certain quantity of gas,preferably of a rare gas which at the same time serves to allow of oreven to facilitate the starting of the mercury arc. 7

It is further possible to dispose within the hollow body'Zmercury-vapour lamps of a different construction from that described,for instance a discharge vessel which is filled in a known manner with arare gas, such as neon, and which contains at some one point a drop ofmercury. A discharge vessel of this type must also comprise two separateelectrodes one of which may take the form of a hot electrode, which islikewise in itself known. The discharge vessel can also be in the formof a U-tube of the type denoted by the reference number 3 in Figs. 2 and3. 0n the starting of a discharge tube of this nature there first takesplace a discharge in the rare gas, and this discharge vapourizes thedrop of mercury, and thus gives rise to the emission of ultra-violetrays. A mercury-vapour lamp of this type also permits of any desiredmovement of the appliance without disturbance ofv its functioning.

In other respects also,

' ing and are connected with the current leads.

The appliance, when about to be put inoperation, is held substantiallyhorizontally but somewhat inclined downwards so that the mercury theindividual component parts of the appliance, for instance the cool-' ingarrangement, can be varied without depart fiows from the reservoirs intothe U-tube and fully fills same. Thereupon the appliance is tiltedupwards a small angle so that the mercury re- .cedes in the two shanksof the U-pipe and flows towards thereservoirs, whereby a light-arcresults between the two columns of mercury. A

slight downward inclination of the forward end of the appliance thussufllces to extinguish the arc, in that the mercury runs forward in thetwo shanks up to the tip of the U-tube where the two mercury columnscontact with each other and a trifling upward tipping of the appliancesuffices to separate the mercury columns and thus to produce the are.

poses, and-it is impossible to use such an ap-- pliance in which themercury can flow unimpeded to and fro within the shank and the tip ofthe In order still further to reduce this tipping movement, it was alsopro-- U-tube for irradiating the larynx, for which purpose it must bedownwardly curved in a sharp curve in order to be able to introduce itinto the Y larynx. In the absence of special precautions,

- the vertically-downwards-directed tip part of the U-tube would thenalways be filled with mercury and in this position an arc cannot bemaintained. As above mentioned, it is indispensable in an sitions of theappliance, especially when the appliance for irradiating the larynx thatthe arc when once it is formed, is maintained in all podownwardly bentU-tube is introduced into the larynx. The mercury vapor lamp of such anappliance must thus when the arc is once formed, be quite insensitive toalterations of position to obtain the necessary stability of the lampdischarge. As compared with this, in the known lamp just described,value is attached to great sensitiveness, as the upward bending of thetip part of the U-tube has been done expressly for the purpose ofreducing as .far as possible the angle about which the appliance must betipped for the purpose of producing and extinguishing the tipping arc.

. I claim:

l. An'appliance for the treatment of the larynx behind the epiglottiswith ultra-violet rays, comprising a hollow sleeve closed at one end andhaving electric current lead-ins mounted therein, a hollow body havingan opened end which tightly adjoins the open end of said sleeve, saidhollow body having such a shapely curved. beakbeing so shaped anddimensioned that the vapor pressure generated by the discharge in theyokelike portion of the tube is capable, in all positions of theappliance, of preventing liquid mercury contained within said tube fromrunning together in the yoke-like portion of the latter when the arcdischarge is once started.

2. An appliance such as described in claim 1, having a handle attachedto said hollow sleeve whereby said appliance may be moved into anydesirable position.

3. An appliance such as described in claim 1, having a handle pivotallyattached to said hollow sleeve whereby said appliance may be moved intoany desirable position.

4. An appliance for the treatment of the larynx behind the epiglottiswith ultra-violet rays comprising a metallic hollow sleeve closed at oneend, a hollow body having an open end which tightly adjoins the open endof said sleeve, said hollow body having such a shapely curved,beak-shaped tip portion composed of'a material transparent toultra-violet rays that it is adaptable to be introduced into the larynxbehind the open epiglottis without any harm and a hot U- shaped andbeak-shaped mercury vapor arc discharge tube having a yoke-like portionarranged within the said tip portion of the hollow body for emitting theultra-violet rays behind the open epiglottis, said are discharge tubealso having two limbs connected with said yoke-like portion, said hollowsleeve having at least one partition mounted within the same formaintaining said discharge tube limbs in their proper position, saidyoke-like portion having a smaller bore than the limbs of said tube,said tube being so shaped and dimensioned that the vapor pressuregenerated by the discharge in the yoke-likeportion of the tube iscapable, in all positions of the appliance, of preventing liquid mercurycontained in the two limbs of said tube from running together in theyoke-like portion of the latter when the arc discharge is once started.

5. An appliance for the treatment of the larynx behind the epiglottiswith ultra-violet rays comprising a hollow sleeve closed at one end andhaving electric current lead-ins mounted therein, said hollow sleevehaving at least one partition mounted therein for supporting saidelectric current lead-ins, a hollow body having an open end whichtightly adjoins the open end of said sleeve, said hollow body havingsuch a shapely curved, beak shaped tip portion composed of a materialtransparent to ultra-violet rays that it is adaptable to be introducedinto the larynx behind the open epiglottis without any harm and a hotU-shaped and beak shaped mercury vapor arc discharge tube having'ayokelike portion arranged within the said tip portion of the hollow bodyfor emitting the ultra violet rays behind the open epiglottis, said aredischarge tube also having two limbs connected with said yoke-likeportion, said yoke-like portion having a smaller bore than the remainderof said discharge tubes, said tube being soshaped and dimensioned thatthe; vapor pressure generated by the discharge in the yoke-like portionof the tube is capable, in all positions of the appliance, of preventingliquid mercury contained in the two limbs of said tube from runningtogether in the yoke-like portion of the latter when the arc dischargeis once started.

6. An appliance for the treatment'of the larynx behind the epiglottiswith ultra-violet rays comprising a hollow sleeve closed at one end andhaving electric current lead-ins mounted therein, a hollow body havingan open end which tightly adjoins the open end of said sleeve, saidhollow body having such a shapely curved, beakshaped tip portioncomposed of a material transparent to ultra-violet rays that it iscapable tovbe introduced into the larynx behind the open epiglottiswithout any harm, and a hot U-shaped and beak-shaped mercury vapor arcdischarge tube having a yoke-like portion arranged with- -in the saidtip portion of the hollow body for in the yoke-like portion of the tubeis capable in all positions of the appliance of preventing liquidmercury contained in the two limbs of said tube from running together inthe yokelike portion of the latter when the arc discharge is oncestarted.

'1'. In an appliance such as described in claim 1 having cooling meanscomprising at least two tubes mounted within said hollow sleeve andextending at one end through the closed end of said hollow sleeve, saidcooling tubes at their opposite ends projecting into said hollow bodywhereby a cooling medium in passing through said cooling tubes will coolsaid tip portion of the hollow body.

8. An appliance for the treatment of the lar- .ynx behind the epiglottiswith ultra-violet rays.

I which tightly adjoins the open end of said sleeve,

said hollow body having such a shapely curved, beak-shaped tip portioncomposed of a material transparent to ultra-violet rays that it isadaptable to' be introduced into the larynx behind the open epiglottiswithout any harm and a hot U-shaped and beak-shaped mercury vapor arcdischarge tube having a yoke-like portion arranged within said tipportion of the hollow body for emitting the ultra-violet rays behind theopen epiglottis, said yoke-like portion having a smaller bore than theremainder of said discharge tube, said tube being so shaped anddimensioned that the vapor pressure generated by the discharge in theyoke-like portion of the tube is capable, in all positions of theappliance, of preventing liquid mercury contained within said tube fromrunning together in the yokelike portion of the latter when the arcdischarge is once.started, cooling means comprising at least two tubesmounted within said hollow sleeve and extending at one end through theclosed end of said hollow sleeve, said cooling tubes at their oppositeends projecting into said hollow body whereby a cooling medium inpassing through said cooling tubes will cool said tip portion of thehollow body, said hollow sleeve having at least one partition mountedtherein, said partition closing said sleeve adjacent said hollowbody-whereby the cooling medium is prevented from entering said hollowsleeve to thereby short-circuit the electric current lead-ins.

9. An appliance for the treatment of the larynx behind the epiglottiswith ultra-violet rays, comprising a hollow sleeve closed at one end andhaving electric current lead-ins mounted therein, a hollow body havingan opened end which tight- 1y adjoins the open end of said sleeve, saidhollow body having such a shapely'curved, beak-shaped tip portioncomposed of a material transparent to ultra-violet rays that it isadaptable to be introduced into the larynx behind the open epiglottiswithout any harm, said hollow body being coated in part with animpermeable material to thereby limit the rays to emit from its extremetip only, and. a hot U-shapedoand beakshaped mercury vapor arc dischargetube having a yoke-like portion arranged within said tip portion of thehollow body for emitting the ultraviolet rays behind the openepiglottis, said yokelike portion having a smaller bore than theremainder of said discharge tube, said tube being so shaped anddimensioned that the vapor pressure generated by the discharge in theyoke-like portion of the tube is capable, in all posltionsof theappliance, of preventing liquid mercury contained within said tube fromrurming together in the yoke-like portion of the latter when the arcdischarge. is once started.

having electric current lead-ins mounted therein,

a hollow body having an opened end which tightly adjoins the open end ofsaid sleeve, saidhollow body having such ashapely curved, beakshaped tipportion composed of a material transparent to ultra-violet rays that itis adaptable to be introduced into the larynx behind the open epiglottiswithout any harm, said hollow body being provided with an impermeableprotective sleeve to thereby limit the rays to emit from its extreme tiponly, and a hot U-shaped and beakshaped mercury vapor arc discharge tubehaving a yoke-like portion arranged within said tip portion of thehollow body for emitting the ultraviolet rays behind the openepiglottis, said yokelike portion having a smaller bore than theremainderof .said discharge tube, said tube v.being so shaped anddimensioned that the vapor pressure generated by the discharge in theyoke-like portion of the tube is capable, in all positions of theappliance, of preventing liquid mercury contained within said tube fromrunning together in the yoke-like portion of the latter when the arcdischarge is once started.

11. An appliance for the treatment of thelarm comprising a hollow sleeveclosed atone end and tached to said hollow body for emitting theultraviolet rays behind the epiglottis, and a hot U- shaped andbeak-shaped mercuryvapor are discharge tube having a yoke-like portionarranged within said tip portion of the hollow ,body for emitting theultra-violet rays behind the open epiglottis, said yoke-like portionhaving a smaller bore than the remainder of said discharge tube, saidtube being so shaped and dimensioned that the vapor pressure generatedby the discharge in the yoke-like portion of the tube is capable, in allpositions of the appliance, of preventing liquid mercury containedwithin said tube from running together in the yoke-like portion of thelatter when the arc discharge is once started.

ALEXANDER CEMACH.

